Bladder Control

Bladder Control Problems: Medications and Treatment Options

Anticholinergics

Anticholinergic medications work by blocking the neurotransmitter acetylcholine from binding to its receptors. For bladder control, these medications block the muscarinic M3 receptors on the smooth muscles of the bladder to prevent contractions that would unintentionally release urine. Medications belonging to this family include Oxybutynin, Tolterodine, Darifenacin, Solifenacin, and Trospium.

Side Effects

Side effects of anticholinergic medications can include:

• Blurry vision
• Constipation
• Dryness of the mouth
• Headaches
• Higher than usual heart rate
• Indigestion
• Insomnia
• Sore throat
• Stomach pain
• Problems with memory
• Urinary retention
• Urinary tract infection (UTI)

Botox

Botox injections in the bladder are sometimes given after traditional anticholinergic medications have failed because people have shown better compliance with Botox over anticholinergics. You may be a candidate for Botox if traditional oral medications have not helped your symptoms. Botox is injected into the bladder muscle by tunneling a thin camera with an injector in through the urethra. The effect of a one-time injection lasts around six months to one year.

Side Effects

The most common side effects of Botox injection include:

• Repeated UTIs while Botox remains in the bladder
• Temporary difficulty completely emptying the bladder for the first few weeks after the injection. If this is the case, you may receive a catheter to completely void the bladder until the body is accustomed to the medication.

Beta-3 Adrenergic Agonists

Beta-3 adrenergic agonists are an alternative class of medications to anticholinergics that generally cause fewer adverse effects. These medications work by activating the beta receptors in the urinary bladder, which allows muscles associated with that area to relax. Medications that fall under the beta-3 adrenergic agonists class of drugs are Myrbetriq (mirabegron) and Gemtesa (vibegron).

Side Effects

Side effects can include:

• Heart palpitations
• Serious cardiovascular complications, such as heart attack or arrhythmias
• Anxiety
• Dry mouth
• Rash
• Nausea and vomiting

Cymbalta (Duloxetine)

Duloxetine is an antidepressant that belongs to a family of medications known as serotonin-norepinephrine reuptake inhibitors (SNRIs). Studies show that duloxetine helps with urinary stress incontinence due to its dual action on both serotonin and norepinephrine.

Side Effects

Side effects can include:

• Constipation
• Decreased appetite
• Dizziness
• Dry mouth
• Fatigue
• Nausea

Over-the-Counter and Alternative Options

Some over-the-counter options for symptoms are available, depending on the type of urinary problem. Oxybutynin is the main ingredient in an OTC patch that you apply to the skin to help with overactive bladder symptoms. However, it is only available over the counter for use in women (under the brand name Oxytrol for Women). Oxybutynin for men must be obtained through a prescription.

Summary

Several medications can help with symptoms associated with bladder control problems (urinary incontinence). These medications can help improve quality of life by reducing urinary frequency and urgency. Work with your healthcare provider to determine the best medication for you based on your type of incontinence and any other concurrent health conditions. Medications may be available by prescription or over the counter.